significant daily activities. The most prevalent chronic conditions (expressed in terms of morbidity from these conditions) in the elderly population include arthritis, hypertension, hearing impairments, and heart conditions (Table 3.15).

Older women experience chronic conditions (such as arthritis and osteoporosis) more frequently than men, and older men experience acute conditions (such as heart attacks) more often than women. In general, the health situation of elderly blacks is poorer than that of elderly whites.

Most elderly people do not need long-term-care assistance, but many suffer from some form of impairment that limits their ability to perform basic activities of daily living (ADLs) (Rowland et al., 1988). A broad set of ADLs includes eating, toileting, dressing, bathing, transferring, going outside, and walking; a “core set” of five ADLs includes all those except walking and going outside. ADLs categorize levels of functional impairment and thus have many health care planning, research, and policy purposes, such as increasing our understanding of the population at risk of institutionalization (or alternatively, in need of long-term-care services).

Functional impairment can be defined in many ways—ranging from difficulty with at least one ADL in the broad set (e.g., difficulty bathing) to